What panic attacks are
A panic attack is a sudden surge of intense fear or discomfort that peaks within minutes. Common symptoms include a racing heart, shortness of breath, chest tightness, shaking, dizziness, heat or chills, tingling, and fear of losing control, fainting, or dying. Panic Disorder is when repeated attacks and fear of future attacks lead to avoidance and distress.
Panic attacks are frightening but not dangerous. They peak and pass.
Common signs and symptoms
- Body: pounding heart, breathlessness, chest pain, sweating, trembling, nausea, dizziness
- Mind: fear of dying, “going crazy,” or fainting; dread of the next attack
- Behavior: avoiding places (stores, highways, meetings), carrying “safety” items, constant body checking
- After-effects: fatigue, worry about triggers, frequent ER/urgent care visits to rule out medical issues
Medical conditions can mimic panic (e.g., thyroid issues, heart rhythm problems). It’s reasonable to get checked, especially after first episodes.
Why panic attacks happen
- False alarms: the body’s fight-or-flight system misfires.
- Sensitivity to sensations: noticing normal body sensations and interpreting them as dangerous.
- Anxiety loop: fear of symptoms intensifies symptoms, creating a cycle.
- Triggers: stress, sleep loss, stimulants (caffeine, decongestants), certain substances.
What helps in the moment
- Ride the wave: remind yourself “This will peak and pass.” Time the attack to prove it ends.
- Slow exhale breathing: exhale slightly longer than inhale (e.g., inhale 4, exhale 6–8).
- Grounding: name five things you see, four feel, three hear, two smell, one taste.
- Drop safety behaviors: if safe, reduce behaviors that keep fear going (e.g., constantly checking pulse).
Evidence-based treatments
- CBT with interoceptive exposure:
- Learn to reinterpret sensations as safe.
- Practice bringing on mild sensations (e.g., spinning in a chair) in a controlled way, then letting them pass.
- Situational exposure:
- Gradually re-enter avoided places (driving, stores, elevators) with support.
- Medications:
- SSRIs/SNRIs are effective; some people use beta-blockers for performance situations.
- Short-term use of certain medications may be considered; discuss risks/benefits.
- Lifestyle supports:
- Sleep regularity, reducing caffeine/nicotine, gentle exercise, stress management.
With practice, most people regain confidence and reduce or stop attacks.
When to seek help now
- Recurrent panic attacks and growing avoidance of daily activities
- Unsure if symptoms are medical or anxiety—see a clinician for evaluation
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I’ve had several sudden episodes with a racing heart and chest tightness that peak within minutes, then resolve. I’m avoiding driving and stores. I’d like CBT and to discuss medication options.”
Outlook
Panic Disorder responds very well to treatment. Many people return to activities they avoided and feel safer in their bodies.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988), Crisis Text Line (text HOME to 741741)
- Find care: FindTreatment.gov, Psychology Today directory, NAMI HelpLine (nami.org/help), ADAA (adaa.org/find-help)
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Confirm in-network benefits, deductible, copay/coinsurance, telehealth coverage, prior authorization, OON reimbursement, OOP maximum; note rep name/date/reference number
- Work/school supports: FMLA, ADA accommodations, EAP; campus counseling for students
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: This information is educational and not a diagnosis. If in crisis, use the resources above.